My Flight Surgeon
Sr. Aviation Medical Examiner
This is one of a series of posts about medical issues potentially affecting a pilot’s ability to obtain a medical certificate. In this series, we will look at common problems seen by the AME, review the requirements the FAA has to consider allowing one to fly and discuss what you need to do to expedite consideration by the FAA to allow you to fly. We plan to go through all of the medical history items in Section 18 on the front of Form 8500-8 over the next several months.
I would suggest that if you are unsure of how to answer these questions in Item 18, you discuss them with your AME before you complete the form. Some things may not be significant while others will require explanation.
Item 18.j. Kidney stone or blood in urine
A single episode of kidney stone requires the airman submit current metabolic evaluation and status report for issuance of the medical certificate. If there is no residual calculi and the metabolic workup is negative, the AME may issue the medical certificate. Complete studies to determine the possible etiology and prognosis are essential to favorable FAA consideration. Determining factors include site and location of the stones, complications such as compromise in renal function, repeated bouts of kidney infection, and need for therapy. Any underlying disease will be considered. The likelihood of sudden incapacitating symptoms is of primary concern. Report of imaging studies (KUB, IVP, or spiral CT) must be submitted in order to conclude that there are no residual or retained calculi.
If there are multiple episodes or retained stone, then the airman is required to submit current metabolic evaluation and status report and the decision regarding the medical certificate is made by the FAA. Complete studies to determine the possible etiology and prognosis are essential to favorable FAA consideration. Determining factors include site and location of the stones, complications such as compromise in renal function, repeated bouts of kidney infection, and need for therapy. Any underlying disease will be considered. The likelihood of sudden incapacitating symptoms is of primary concern. Report of imaging studies (KUB, IVP, or spiral CT) must be submitted in order to conclude that there are no residual or retained calculi. If they grant a Special Issuance certificate, then at subsequent flight physicals, the AME may issue if the following guidelines are met:
Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:
An Authorization granted by the FAA;
A statement from your treating physician regarding the location of the retained stone(s), estimation as to size of stone, and likelihood of becoming symptomatic; and
A current report of appropriate imaging study (IVP, KUB, Ultrasound, or Spiral CT Scan) and provide a metabolic work-up, both performed within last 90 days.
The Examiner must defer to the AMCD or Region if:
If the treating physician comments that the current stone has a likelihood of becoming symptomatic;
If the retained stone(s) has moved when compared to previous evaluations; or
If the stone(s) has become larger when compared to previous evaluations.
Hematuria (blood in the urine): A history of recent or significant hematuria requires further evaluation. This will require imaging studies and possibly a urology consultation.
* Italicized text is from FAA documents
I would suggest that if you are unsure of how to answer these questions in Item 18, you discuss them with your AME before you complete the form. Some things may not be significant while others will require explanation.
Item 18.j. Kidney stone or blood in urine
A single episode of kidney stone requires the airman submit current metabolic evaluation and status report for issuance of the medical certificate. If there is no residual calculi and the metabolic workup is negative, the AME may issue the medical certificate. Complete studies to determine the possible etiology and prognosis are essential to favorable FAA consideration. Determining factors include site and location of the stones, complications such as compromise in renal function, repeated bouts of kidney infection, and need for therapy. Any underlying disease will be considered. The likelihood of sudden incapacitating symptoms is of primary concern. Report of imaging studies (KUB, IVP, or spiral CT) must be submitted in order to conclude that there are no residual or retained calculi.
If there are multiple episodes or retained stone, then the airman is required to submit current metabolic evaluation and status report and the decision regarding the medical certificate is made by the FAA. Complete studies to determine the possible etiology and prognosis are essential to favorable FAA consideration. Determining factors include site and location of the stones, complications such as compromise in renal function, repeated bouts of kidney infection, and need for therapy. Any underlying disease will be considered. The likelihood of sudden incapacitating symptoms is of primary concern. Report of imaging studies (KUB, IVP, or spiral CT) must be submitted in order to conclude that there are no residual or retained calculi. If they grant a Special Issuance certificate, then at subsequent flight physicals, the AME may issue if the following guidelines are met:
Examiners may re-issue an airman medical certificate under the provisions of an Authorization, if the applicant provides the following:
The Examiner must defer to the AMCD or Region if:
Hematuria (blood in the urine): A history of recent or significant hematuria requires further evaluation. This will require imaging studies and possibly a urology consultation.
* Italicized text is from FAA documents
